摘要
目的观察失眠伴抑郁障碍患者的下丘脑-垂体-肾上腺轴(HPA)激素指标[皮质醇(CORT)、促肾上腺皮质激素释放激素(CRH)]及5-羟色胺(5-HT)分泌特点,评估逍遥助阳方联合蜡泥灸治疗失眠伴抑郁障碍的临床疗效。方法90例失眠伴抑郁障碍患者,随机分为灸药结合组、逍遥助阳组、佐匹克隆组,每组30例。逍遥助阳组采用逍遥助阳方治疗,灸药结合组采用逍遥助阳方联合中药蜡泥灸治疗,佐匹克隆组采用佐匹克隆治疗。比较三组患者治疗前后匹兹堡睡眠质量指数量表(PSQI)、汉密尔顿抑郁量表(HAMD)评分,CORT、5-HT、CRH水平及昼夜斜率。结果治疗后,三组PSQI和HAMD评分均低于治疗前,且灸药结合组PSQI评分(10.43±2.06)分低于逍遥助阳组的(11.77±2.50)分,HAMD评分(22.83±6.86)分低于佐匹克隆组的(26.93±4.81)分,差异有统计学意义(P<0.05)。治疗后,灸药结合组08:00 CORT≥300 nmol/L患者08:00的CORT水平及昼夜斜率均低于治疗前,20:00的CORT水平高于治疗前,且08:00的CORT水平低于佐匹克隆组,20:00的CORT水平高于佐匹克隆组,昼夜斜率低于逍遥助阳组、佐匹克隆组,差异有统计学意义(P<0.05);逍遥助阳组08:00 CORT≥300 nmol/L患者08:00的CORT水平低于治疗前,昼夜斜率低于治疗前及佐匹克隆组,差异有统计学意义(P<0.05)。治疗后,灸药结合组08:00 CORT<300 nmol/L患者08:00的CORT水平及昼夜斜率均高于治疗前,20:00的CORT水平低于治疗前,且08:00的CORT水平及昼夜斜率高于逍遥助阳组、佐匹克隆组,20:00的CORT水平低于佐匹克隆组,差异有统计学意义(P<0.05);逍遥助阳组08:00 CORT<300 nmol/L患者20:00的CORT水平低于治疗前,昼夜斜率高于治疗前,且20:00的CORT水平低于佐匹克隆组,昼夜斜率高于佐匹克隆组,差异有统计学意义(P<0.05)。08:00 CORT≥300 nmol/L患者的昼夜斜率普遍偏高,08:00 CORT<300 nmol/L患者的昼夜斜率则偏平,差距较大。昼夜斜率偏高者治疗后
Objective To observe the secretion characteristics of hypothalamic-pituitary-adrenal axis(HPA)hormone indexes[cortisol(CORT),corticotropin-releasing hormone(CRH)]and 5-hydroxytryptamine(5-HT)in patients with insomnia and depression disorder,and evaluate the clinical efficacy of Xiaoyao Zhuyang Prescript combined with wax mud moxibustion in the treatment of insomnia with depression disorder.Methods A total of 90 patients with insomnia and depression were randomly divided into moxibustion with drug group,Xiaoyao Zhuyang group and zopiclone group,with 30 cases in each group.Xiaoyao Zhuyang group was treated with Xiaoyao Zhuyang prescription,moxibustion with drug group was treated with Xiaoyao Zhuyang prescription and wax mud moxibustion,and zopiclone group was treated with zopiclone.The Pittsburgh Sleep Quality Index Scale(PSQI),Hamilton Depression Scale(HAMD)scores,CORT,5-HT,CRH levels and diurnal slope were compared before and after treatment in three groups.Results After treatment,PSQI score and HAMD score in all three groups were lower than those before treatment in this group;PSQI score of(10.43±2.06)points in moxibustion drug combination group was lower than that of(11.77±2.50)points in the Xiaoyao Zhuyang group;HAMD score of(22.83±6.86)points was lower than that of(26.93±4.81)points in zopiclone group;the difference were statistically significant(P<0.05).After treatment,patients with 08:00 CORT≥300 nmol/L in the moxibustion with drug group had lower CORT level and diurnal slope at 08:00 than those before treatment in this group,CORT level at 20:00 was higher than that before treatment in this group;CORT level at 08:00 in the moxibustion with drug group was lower than that in the zopiclone group,and CORT level at 20:00 was higher than that in the zopiclone group;the diurnal slope in moxibustion with drug group was lower than that of Xiaoyao Zhuyang group and zopiclone group;the differences were statistically significant(P<0.05).The CORT level at 08:00 of patients with 08:00 CORT≥300 nmol/L in Xiaoyao Z
作者
唐宜春
郝晓东
方圆
杨翠霞
丁海明
梁镇忠
TANG Yi-chun;HAO Xiao-dong;FANG Yuan(Panyu Hospital of Traditional Chinese Medicine,Guangzhou 511400,China)
出处
《中国实用医药》
2023年第22期36-41,共6页
China Practical Medicine
关键词
失眠
抑郁
逍遥助阳方
蜡泥灸
5-羟色胺
下丘脑-垂体-肾上腺轴
Insomnia
Depression
Xiaoyao Zhuyang prescription
Wax mud moxibustion
5-hydroxytryptamine
Hypothalamic-pituitary-adrenal axis
